Tales from the Tail — Does Anal Sex Give You the Need to Pee?

Dr. Evan Goldstein
5 min readFeb 23, 2021

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Client’s Tale.

Every single time I get fucked, I feel the urge to piss. No joke. And that’s not really the best sensation I want to be experiencing. I want the mind blowing, fuck-me-in-the-ass-and-fill-me-up-with-all-your-gooey-warmness kinda sex. You know what I’m talking about. However, my bladder instead feels like it’s going to burst no matter whose dick is in my ass. And for all those thinking it right now — yes, I use the bathroom before bottoming. It doesn’t make a difference.

I do get rock hard when someone is inside me. No issues there. I am able to fully relax and allow my tops to go balls to the wall, but that’s also when my body hits a point of piss and no return. It’s curious to me because, who can actually take a piss when they are fully erect? I am sure many have tried — I know I have. It’s nearly impossible to hit the center of the goddam toilet.

I am at my wits’ end and have gone so far as to take a hiatus from bottoming. It was also at that point that I decided to bring it up with my ass doctor, Dr. Evan Goldstein at Bespoke Surgical. I was there for my yearly check up, which has become routine since recovering from an anal tear he fixed. First, he checked to make sure my anal fissure was fully healed and functional. It was then decided that that was not the issue. Then, he checked the relaxation needed from the Botox he had administered during my surgery. That had worn off, so that wasn’t the culprit. So what the fuck was it?!

Apparently, it all came down to my pelvis and my rectal angle. If you’re saying “huh?” to yourself, you’re not alone. I was just as confused. Dr. Goldstein explained that I have a smaller pelvis (no, that doesn’t mean a smaller cock) and because of how my parts are angled, no matter what sized cock is inside me, it hits my prostate and all of its surrounding structures, causing the urgent sensation to take a piss. We performed some simple maneuvers of (more on this below) and also made a few appointments with the pelvic floor therapist in the office to help with understanding my angulation and how to work with it. All it took was a small tweak to take any sized D and — bam — now the need to pee had vanished. Weird, right? But listen — I still can piss on you if that’s your fetish.

My Discussion.

I’ve said it once and I’ll keep repeating it — the ass is not overly complex. But we all know that inside and out, it’s made up of a lot of shit (sometimes literally). What I am trying to do through Bespoke Surgical is breakdown the anatomical, physical, and mental components that go into all things anal.

There is always a lot to think about, but it’s important to first start by addressing your current issues. What do I mean by this? Identify the sensations that we don’t like. The ones that may kill your boner or prevent you from ejaculating. Also, identify situations that limit your success in receiving or, in this case, the I-feel-like-I-need-to-piss sensations that consistently and constantly present themselves when bottoming.

Let’s go a little deeper into my thought process and approach. I ask my clients first about their sexual history and then get a detailed understanding of what’s what, followed by a complete internal and external examination. During this, I take local swabs and/or bloodwork (with appropriate testing) to make sure that we rule out not only anal specific issues, but also anything that can be a potential culprit, like the prostate and/or the pelvic floor. We may go further into diagnosis if the easy things don’t provide the relieve that’s needed for the particular client.

In this client’s case, I performed a procedure months before this, which gave me a full understanding of his whole hole — including his internal angulation. What do I mean by that? His anal canal points directly to his prostate. So any dick — big or small — will slip right in, which is great, but as it’s penetrating him internally, it’s going to constantly be smacking up against a barrier. I define this angle as an anterior tunnel. Constant pressure in that region can definitely cause prostatitis or, in this case, the sensation that you have to pee. The front of the cock hits that anterior wall only (and repeatedly). For some people, they love that direct prostate stimulation. For others, it causes many potential pitfalls.

So how the fuck do we solve this issue?

Know your angles, baby. Try experimenting with toys, manipulating them to offset that annoying angulation. By simply moving your hand on the toy frontwards, or towards your cock and balls, it will relieve the constant pressure that may create that uncomfortable symptom. Real world penetration (either with a toy or a partner) is the only thing that can truly help because it allows you and your partner to learn your anatomy and how to truly optimize its function.

I’ll leave you with one last tip. A small tweak after someone enters you — like moving your pelvis up or back — allows for the cock to finally be in a space that allows a full range of motion. It may not seem like much, but these small movements will diminish any potential negative ramifications of sex, while maximizing the positive sensations. Give it a try. What we will experience over time is a truer understanding of the pelvis’ contents and this will improve everyone’s sexual play. Sure, piss can be hot, as long as it’s consensual and done at the right time. But to be pounded and feel as if you need to piss with each thrust? That doesn’t sound as sexy.

Don’t forget to stay in touch on Instagram: me and Bespoke Surgical.

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Dr. Evan Goldstein
Dr. Evan Goldstein

Written by Dr. Evan Goldstein

NYC Gay Surgeon discussing ASS: A\rt, S\cience, and S\ex www.bespokesurgical.com/

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